Survey

ROEBIC Laboratory's Free Restaurant & Food Service Facility Survey

Please fill out this survey as complete as possible and submit. Also print a copy of your completed survey for your reference. One of Roebic's Professional Consultants will contact you via e-mail or phone to provide you with a Custom Grease & Drain Treatment Program designed exclusively for your establishment.

* Required

Facility Information

Establishment name: *

Contact name: *

Address:

City:

State:

Zip/postal code:

Area code & phone number: *

Area code & fax number:

E-mail address: *

Problem Experienced

1. What is the nature of the problem? Odor? Grease build-up or both? *

Odor Grease Buildup Both Please explain *

2. What type of food is served? *

3. Please explain your grease management system (example: 1000 gal. Tank, grease interceptor or lift standing.) *
Please provide details.

4. What is your seating capacity?

5. How many meals per day, on average, do you serve?

6. Is establishment under any city order to clean up a problem?

Yes No If yes, please explain problem

7. What are the restaurant's hours of operation?

8. Is your dishwasher on the same line as your grease system?

9. Are you currently using any products to treat your grease trap or plumbing system (including drains, mainline or septic system)?

Yes No If "yes" what are you using and how well is it working?

10. Notes / Comments:

A Roebic Consultant may call you to obtain more information for proper assistance.

ROETECH

Patented Bacterial Solutions

Survey

ROEBIC Laboratory's Free Restaurant & Food Service Facility Survey

Facility Information

Problem Experienced